Throughout February, we commemorate Black History. During the week of April 11-17, we nationally honor and bring awareness to Black Maternal Health. And in May, we celebrate Mother’s Day. But amidst these beautiful celebrations, there is a sobering reality that mothers and birthing persons throughout our nation face increasing health risks.
The US has the highest rate of maternal deaths of all the high-income nations of the world,1 and from 2018 to 2021, death rates worsened significantly.2 This is an alarming maternal health crisis. Most impacted by these disparities are Black women in the US, who are at 2-6 times higher risk of severe disease or dying of pregnancy related causes compared to other groups of women.2,3 Major differences like this indicate health disparities, which are differences in health outcomes linked with social or economic disadvantages, unequal access to health care and unequal quality of healthcare that negatively affect vulnerable groups of people. 4 Social and economic factors such as food, housing, and transportation as well as childcare and safety from violence also impact maternal outcomes.5 Leading obstetrics and gynecology organizations also recognize the impact of historic and present-day racism and bias in the healthcare system, policies, and delivery of care. 6 So, there are a lot of factors to consider in working to improve maternal health outcomes.
Close evaluation shows that 60-70% of maternal deaths are preventable. 3 So what can be done? Congresswoman Lauren Underwood, a registered nurse (RN) and the youngest Black woman to ever serve in Congress, has championed the Black Maternal Health Momnibus Act (H.R. 3305/S. 1606). 7 On April 3, 2024, over $100 million in Momnibus funding was signed into law. The Momnibus Act is designed to end preventable maternal deaths, maternal health complications, and health disparities. According to the Black Maternal Health Caucus, bipartisan agreement made it possible to fund evidence-based programs to support mothers and address the issues contributing to the US maternal health crisis. 8 Efforts include:
- Training more maternal health professionals of color, recognizing the improved outcomes with culturally congruent care
- Funding programs, technology, and telehealth initiatives
- Limiting the effects of climate change and public health emergencies
- Improving vaccination rates
- Extending postpartum and breastfeeding support
As we celebrate Mother’s Day and this policy victory, we can give the gift of commitment toward improving maternal health.
What can you do, you ask?
Share your story. 9 Statistics are important, but we must never forget the individuals they represent. People you may have heard about, like Serena Williams, Allyson Felix, and Kira Johnson, have pregnancy and birth stories that were wrought with challenges and, for some, even death, highlighting the experiences of Black women. However, many stories have not yet been heard. To share your story, you can email BlackMaternalHealthCaucus@mail.house.gov.
Be an ally. 10 As a healthcare professional, a neighbor, friend, or family member, you can do the following to serve as an ally:
- Vote for leaders and local measures to increase awareness and address maternal health disparities.
- Listen to the experiences of pregnant people and reflect on personal or system bias that may impact their health.
- Support healthy behaviors like breastfeeding, cardiovascular health, and quitting smoking.
- Learn about early signs that there may be a problem during pregnancy (such as fever, frequent or severe headaches, severe stomach pain, etc.).
- Offer support through babysitting, giving a ride to an appointment, or just visiting—you never know what a kind word and a listening ear can do.
We are facing an unprecedented maternal health crisis, with high rates of maternal mortality, morbidity, and disparities. Maternal health policies such as the Black Maternal Health Momnibus Act have the potential to make a significant impact, but it will also take the committed efforts of concerned citizens and health care professionals. Together we can improve maternal health outcomes in the US, so let’s all get on the mommy bus!
Author Bio:
Lisa R. Roberts, DrPH, MSN, RN
Dr. Roberts is a Professor and the Research Director at the School of Nursing, with a secondary appointment in the Division of Interdisciplinary Studies in the School of Behavioral Health. Her primary research interest concerns maternal health and coping with perinatal grief. Her research interests also include mixed methods and community-based self-help interventions, addressing issues impacting health disparities and vulnerable populations. Her clinical focus as a Family Nurse Practitioner is prevention and primary care.
Juliana Fuller, MSN, FNP-C, RN
Ms. Fuller is a family nurse practitioner working at SAC Health San Bernardino Women’s Health Clinic, specializing in reproductive and gynecological health care. Recognizing the maternal health crisis has ignited her focus toward the goals of health equity and reproductive justice.
References
- Anderson BA, Roberts LR, editors. The Maternal Health Crisis in America: Nursing Implications for Advocacy and Practice. New York, NY: Springer Publishing Company; 2019.
- Hoyert DL. Maternal mortality rates in the United States, 2021. 2023.
- MacDorman MF, Thoma M, Declcerq E, Howell EA. Racial and ethnic disparities in maternal mortality in the United States using enhanced vital records, 2016‒2017. American journal of public health. 2021;111(9):1673-81.
- Stanhope M, Lancaster J. Public Health Nursing: Population-Centered Health Care in the Community. 10th ed. St. Louis, Missouri: Elsevier Health Sciences; 2020. 1079 p.
- Joseph NT, Stanhope KK, Geary F, McIntosh M, Platner MH, Wichmann HK, et al. Social Determinants of Health Needs and Perinatal Risk in Socially Vulnerable Pregnant Patients. Journal of Health Care for the Poor and Underserved. 2023;34(2):685-702.
- The American College of Obstetricians and Gynecologists. Joint statement: Collective action addressing racism: ACOG; 2020 [updated Aug. 27, 2020. Available from:https://www.acog.org/news/news-articles/2020/08/joint-statement-obstetrics-and-gynecology-collective-action-addressing-racism
- S.1606- Black Maternal Health Momnibus Act.
- Adams, Underwood annouce maternal health priorities included in FY2024 bipartisan appropriations law [Press release]. Washington D.C.: House.gov; 2024 [April 3, 2024:[Available from:Assembly Bill 1286: https://blackmaternalhealthcaucus-underwood.house.gov/media/press-releases/adams-underwood-announce-maternal-health-priorities-included-fy2024-bipartisan
- About Black maternal health: United States House of Representatives; 2024 [Available from: https://blackmaternalhealthcaucus-underwood.house.gov/about-black-maternal-health
- Office of the Surgeon General (OSG). The Surgeon General’s Call to Action to Improve Maternal Health. Washington D.C.: US Department of Health and Human Services; 2020. Available from: https://www.ncbi.nlm.nih.gov/books/NBK568218/